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What could be the reason for swollen red toe and soreness in bottom with diabetes?

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Practicing since : 2006
Answered : 1583 Questions
My husband's 3rd toe is red, swollen, & intermittently painful, and has been since 8/13. His very recent MRI confirmed NO osteomyletis, only some arthritis. He's had no trauma. He has diabetes. He took antibiotics for more than 1 month. His podiatrist and internist are both stumped. I'd like to upload a picture. He is 78, 5'9" and weighs 250. Besides the redishness on top of the toe, there's a sore on the bottom that's not healing and a sort of purplish crusty sore, very small.
Posted Mon, 30 Dec 2013 in Diabetes
Answered by Dr. Basheer Ahamed 6 hours later
Brief Answer: Diabetic foot. Detailed Answer: Hello, With the back ground of diabetes, there are three possible reasons for foot sore and ulcer. 1. We have ruled out bone infection by MRI. However it did indicate presence of joint inflammation (Arthritis). The redness and pain is possible due to inflammation. Consult with your doctor if he can be started on a lose dose steroids to control the inflammation and redness if his blood sugar is under control. 2. Secondly arterial diseases like block in the vessels and arteritis may present as pain, redness and ulcer due to lack of blood and oxygen. To rule out this I advice my patients to undergo Doppler scan to assess the vascular status. 3. Thirdly nerve damage due to long standing diabetes which we call as diabetic neuropathy also presents with pain, redness and prone to ulcer due to trivial trauma because of loss of sensation. A nerve conduction study will help to assess the nerve damage. Medicines like Gabapentin is prescribed for such problems. I feel your husband should be investigated further for both arterial disease as well as neuropathy. A good nursing care, tight control of blood sugar and medication will help your husband out of this problem. Hope the answer helps your. Let me know if there is any clarification. Regards.
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